Performance evaluation of the pneumatic tube system for urine, haematology, coagulation, biochemical and immunological tests

Abstract Objectives Medical pneumatic tube systems (PTSs) are gradually being applied in clinical laboratories. PTSs not only decrease the specimen turnaround time but also reduce the burden of manual transportation. However, different types of automatic transmission systems or different design schemes may have various impacts on the samples. Therefore, laboratories should conduct an evaluation prior to using PTSs to understand their effects on laboratory tests. We aimed to explore the impact of PTSs on urine, haematology, coagulation, and biochemical and immunological test parameters. Methods We compared the effects of PTS and manual transport on test results. Urine tests included quantitative parameters of urine cells; haematology tests included complete blood count (CBC) parameters and coagulation function indices; biochemical tests included enzyme and electrolyte indices; immunological tests included the detection of pro-gastrin-releasing peptide (ProGRP) and cytokeratin 19 fragment (CYFRA21-1). Results Transmission via the PTS led to a significant increase in LDH, CK-MB and hemolysis index absorbance levels. Cohen’s d values indicated that the impact of PTS on LDH, CK-MB, and hemolysis index absorbance reached a large effect, which was consistent with the statistical significance indicate by the p values. Meanwhile, the compliance rate of bias between the two groups of LDH was relatively low, and the comparison based on the allowable bias derived from biological variation failed. Bias compliance rates for quantitative urine white blood cell (UWBC) and quantitative urine red blood cell (URBC) did not meet the required criteria. No statistically significant differences were observed between the two transportation methods for the remaining outcomes. Conclusions The PTS is not suitable for transporting samples containing UWBC, URBC, LDH and CK-MB at our institution. It can be used for transporting samples for haematology, coagulation, immunological and other biochemical tests in the laboratory. All medical institutions should conduct performance evaluations before using PTSs to understand their impact on laboratory test parameters.